International Journal of Hematology

, Volume 100, Issue 6, pp 582–591 | Cite as

Comparison of reduced conditionings combining fludarabine with melphalan or 3-day busulfan in patients allografted for myeloid neoplasms

  • Ludek Raida
  • Zuzana Rusinakova
  • Edgar Faber
  • Romana Szotkowska
  • Peter Rohon
  • Ivana Skoumalova
  • Martina Divoka
  • Zuzana Pikalova
  • Karel Indrak
  • Katerina Langova
Original Article
First Online:
Received:
Revised:
Accepted:

Abstract

In the present study we compared outcomes of patients with myeloid neoplasms undergoing allogeneic hematopoietic stem cell transplantation after fludarabine-based regimens with melphalan (FM140) or 3-day busulfan (FB3). The FM140 and FB3 combinations were administered to 21 and 27 patients, respectively. Efforts for early reduction (from day +30 to 60) and discontinuation (until day +100 to 130) of prophylactic immunosuppression were a component of the post-transplant approach. Following FB3 patients suffered from more severe stomatitis (P = 0.013). In contrast, other manifestations of regimen-related toxicity were more frequent in the FM140 group (P = 0.048). There were no statistically significant differences in the development of graft-versus-host disease, non-relapse mortality, post-transplant remission rate, or relapse incidence. Two-year disease-free survival rates were comparable in the two cohorts (66 vs. 55 %; P = 0.751), and so were the overall survival rates (64 vs. 62 %; P = 0.715). The outcomes of allografted patients with myeloid neoplasms were comparable after the FM140 and FB3 regimens. Relatively high therapeutic response in both groups may have been influenced by early reduction and discontinuation of prophylactic immunosuppression followed by effective immunological control of the malignant clone.

Keywords

Myeloid neoplasms Allogeneic hematopoietic stem cell transplantation Fludarabine Busulfan Melphalan 
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Notes

Acknowledgments

This work was supported by the project LF-2014-001 of Palacky University in Olomouc.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© The Japanese Society of Hematology 2014

Authors and Affiliations

  • Ludek Raida
    • 1
  • Zuzana Rusinakova
    • 1
  • Edgar Faber
    • 1
  • Romana Szotkowska
    • 1
  • Peter Rohon
    • 1
  • Ivana Skoumalova
    • 1
  • Martina Divoka
    • 1
  • Zuzana Pikalova
    • 1
  • Karel Indrak
    • 1
  • Katerina Langova
    • 2
  1. 1.Department of Hemato-Oncology, University Hospital and Faculty of Medicine and DentistryPalacky UniversityOlomoucCzech Republic
  2. 2.Department of Medical Biophysics, Faculty of Medicine and DentistryPalacky UniversityOlomoucCzech Republic

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